Endoscopic carpal tunnel release surgery: a case study in Vietnam
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(2019) 14:149
RESEARCH ARTICLE
Open Access
Endoscopic carpal tunnel release surgery: a case study in Vietnam Dung Tran Trung1*, Thanh Ma Ngoc1, Du Hoang Gia2, Son Dinh Ngoc1, Son Le Manh3, Toan Duong Dinh1, Thanh Dao Xuan1, Minh Do Van1 and Long Nguyen Hoang3
Abstract Background: This study aims at investigating the outcome and electrophysiologic recovery of 150 carpal tunnel syndrome hands after single-portal endoscopic surgery. Methods: Patients with the cross-sectional area of the median nerve being 13–15 mm2 on ultrasound or abnormal sensory nerve conduction velocity on EMG are assigned to endoscopic surgery that cuts the decompressing transverse ligament to avoid the emergence of severe symptoms, such as muscular atrophy and loss of hand function. Results: Single-portal endoscopic release is a safe and efficacious option for carpal tunnel release. The findings demonstrate encouraging results. Conclusion: The endoscopic carpal tunnel release with the placement of a MicroAire system is a safe and effective method for treating carpal tunnel syndrome. Keywords: Carpal tunnel syndrome, Single portal endoscopic
Introduction The carpal tunnel syndrome (CTS) is a common problem that affects the hand and wrist. The syndrome results from compression or non-inflammatory ischemia of the median nerve. This pathology occurs in 1.5–3% of the adult population and in 5% of specific risk groups (smoking people, people with obesity, rheumatoid arthritis, diabetes, hypothyroidism, multiple sclerosis) [1]. Carpal tunnel syndrome can occur at any age, but the peak incidence is between ages 40 and 60. CTS is more common in women (female:male ratio = 5:1) [2, 3]. The carpal tunnel syndrome is manifested by hypoesthesia, paresthesia, and pain in the affected area. These manifestations are followed by the thenar hypertrophy and a sharp decrease in hand function. The CTS treatment includes non-operative procedures and surgical intervention. It could be cured completely if treated promptly. On the contrary, late treatment causes lesions and prolonged effects that seriously affect work and activities of daily living. Non-operative interventions (wrist splints and steroid injections) are assigned at the early stages of CTS. Although such interventions reduce * Correspondence: [email protected]; [email protected] 1 Hanoi Medical University, No 1, Ton That Tung Street, Hanoi 10000, Vietnam Full list of author information is available at the end of the article
CTS symptoms in a short time, they (symptoms) reoccur [4–6]. The carpal tunnel release (CTR) surgery, in which the surgeon cuts the transverse carpal ligament, is the most radical treatment, assigned in moderate and severe CTS (stages 2 and 3 by R. Szabo [7]) or when non-operative treatment fails [5]. In Vietnam, open surgery is a common treatment for CTS that had been in use for years, while the endoscopic surgery is an innovation with many advantages (esthetically small scar surgery on wrist, painlessness and faster recovery time) [8–11]. The endoscopic carpal tunnel
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